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Serological and tissue markers of HBV infection in chronic active hepatitis patients and in healthy carriers of HBsAg

Serologische und Gewebe-Marker für die HBV-Infektion bei Patienten mit chronisch aktiver Hepatitis und gesunden Trägern von HBsAg

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Summary

We studied serological and tissue markers of Hepatitis B virus (HBV) infection in seven healthy carriers of HBsAg and in 58 patients with chronic active hepatitis (CAH), of whom 20 were HBsAg positive and 38 HBsAg negative. Surface antigen was found as the only marker of HBV infection in the liver tissue of all healthy carriers and HBsAg positive in 40% of the CAH patients. Core antigen was detected only in CAH patients: 7/20 HBsAg positive (in two alone and in five together with HBsAg) and 5/38 HBsAg negative (four with circulating anti-HBs and anti-HBc and one with only anti-HBc). All the healthy carriers of the surface antigen presented HBsAg in the liver as the only marker of HBV. Furthermore, all healthy carriers were found to be anti-HBe positive, whereas in the 16 HBsAg positive CAH patients examined for the e system, HBeAg and anti-HBe were found with the same frequency (43.7%). Of the 33 HBsAg negative CAH patients examined, anti-HBe was present in four who also had circulating anti-HBc and anti-HBs. In HBsAg positive CAH patients core antigen was found in the liver tissue of 4/7 HBeAg positive cases and in 2/7 anti-HBe positive, while surface antigen was detected in 3/7 HBeAg positive, 5/7 anti-HBe positive and in the two HBeAg/anti-HBe negative individuals. In HBsAg negative CAH patients, surface antigen was never found in the liver tissue; core antigen was detected, however, in five who had circulating anti-HBc (one in the presence and four in the absence of anti-HBe). In conclusion, from these data it would appear that the various serological patterns of HBV infection, particularly as concerns the presence of antibodies and presence or absence of HBsAg, are not invariably able to predict whether or not HBV antigens are present in liver tissue or, in other words, if active replication does occur.

Zusammenfassung

Wir haben serologische und Gewebe-Marker für die Hepatitis-B-Virus (HBV) Infektion bei sieben gesunden Trägern von HBsAg und 58 Patienten mit chronisch aktiver Hepatitis (CAH) geprüft, von denen 20 HBsAg positiv und 38 HBsAg negativ waren. Es zeigte sich, daß das Oberflächenantigen als einziger Marker der HBV-Infektion im Lebergewebe aller gesunden Träger positiv war und bei 40% der CAH-Patienten nachgewiesen werden konnte. Das Core Antigen wurde nur bei CAH-Patienten entdeckt: bei 7/20 HBsAg positiven Fällen (davon zweimal allein und fünfmal zusammen mit HBsAg) und bei 5/38 HBsAg negativen Kranken (viermal zusammen mit zirkulierendem anti-HBs und anti-HBc und einmal nur mit anti-HBc). Alle gesunden Oberflächenantigen-Träger wiesen in der Leber ausschließlich HBsAg als HBV-Marker auf. Es zeigte sich außerdem, daß alle gesunden Carrier anti-HBe positiv waren; dagegen konnten bei den 16 HBsAg positiven CAH-Patienten, die bezüglich des e Systems überprüft wurden, HBeAg und anti-HBe gleich häufig nachgewiesen werden (43,7%). Anti-HBe fand sich bei vier der 33 HBsAg negativen Patienten mit chronisch aktiver Hepatitis, sie wiesen gleichzeitig zirkulierendes anti-HBc und anti-HBs auf. Im Lebergewebe der HBsAg positiven CAH-Patienten wurde das Core Antigen bei 4/7 HBeAg positiven und bei 2/7 anti-HBe positiven Fällen gefunden; das Oberflächenantigen ließ sich bei 3/7 HBeAg positiven, bei 5/7 anti-HBe positiven und bei zwei HBeAg/anti-HBe negativen Kranken nachweisen. Bei HBsAg negativen Patienten mit chronisch aktiver Hepatitis wurde das Oberflächenantigen niemals im Lebergewebe gefunden. Hingegen entdeckten wir Core Antigen bei fünf Fällen, die zirkulierendes anti-HBc aufwiesen (in einem Fall gleichzeitig mit und viermal ohne den Nachweis von anti-HBe). Aus diesen Befunden könnte man schließen, daß die verschiedenen serologischen Muster der HBV-Infektion, insbesondere die Anwesenheit von Antikörpern und Vorhandensein oder Fehlen von HBsAg, nicht ausnahmslos geeignet sind, eine Voraussage zu treffen, ob sich HBV-Antigene im Lebergewebe befinden, das heißt, ob eine aktive Virusreplikation stattfindet.

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Authors and Affiliations

  1. Istituto di Semeiotica Medica, Università di Napoli, Italy

    C. Del Vecchio Blanco,  N. Caporaso,  G. Ambrogio &  A. Balzano

  2. Istituto di Virologia, Università di, Milano, Italy

    A. R. Zanett &  P. Ferrom

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  1. C. Del Vecchio Blanco
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  2. N. Caporaso
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  3. G. Ambrogio
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  5. A. R. Zanett
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  6. P. Ferrom
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Del Vecchio Blanco, C., Caporaso, N., Ambrogio, G. et al. Serological and tissue markers of HBV infection in chronic active hepatitis patients and in healthy carriers of HBsAg. Infection 9, 126–130 (1981). https://doi.org/10.1007/BF01642119

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